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Crit Care Nurse 2003 Apr; 23(2): 21
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Letters to the Editor

Homocysteine testing

I read with a great deal of interest the article concerning the relationship between coronary artery disease and homocysteine levels by Coffey and colleagues ("Reducing Coronary Artery Disease by Decreasing Homocysteine Levels," February 2003:25–30). I was impressed by the fact that both men and women were included in the studies cited by the authors. Of particular interest to me was their mention of the study by Foody et al, which differentiated between the impact of elevated homocysteine levels in women versus men in terms of risk for coronary artery disease. As my dissertation topic will be the impact of elevated homocysteine levels in women, I am frequently perusing the literature for articles such as this one.

In the Nursing Implications section of the article, reference was made to the importance of measuring homocysteine levels in patients in the at-risk population. As I have not noticed an increased frequency in homocysteine testing in the areas of the country where I have practiced, I was left wondering how prevalent homocysteine testing is.

Moreover, I thoroughly enjoyed the Editorial in the February issue and agree that it is, indeed, newsworthy that an increased patient load will negatively impact patient health but it is, as the Editor stated so well, not a report of recent events.

Kathleen M. Elliott, RN, MN, CCRN
 Decatur, Ala

 

The authors respond

In response to the question regarding the prevalence of homocysteine testing, we are seeing a definite rise in testing among high-risk patients. Although the prevalence is not yet measurable nationwide, we can comment on the use in our local area. Testing is most often ordered for high-risk individuals through the clinics such as the Cardiovascular Risk Reduction Clinic at the University of North Carolina Hospitals. Per American Heart Association guidelines, population-wide screening is not recommended. However, homocysteine testing is proving valuable when utilized for identified high-risk patients.

Michelle Coffey, RN, BN
 Gregory K. Crowder, RN, BSN, RCIS
 Dennis J. Cheek, RN, PhD
 Durham, NC

Chapel Hill, NC





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